Christian Housing-Mesa, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CHRISTIAN HOUSING-MESA, INC.

Practice address

118 S 70TH St
Mesa, AZ 85208-1007

Phone

(480) 654-1800

Fax

(480) 218-2617

NPI assigned

Apr 5, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie Klevenberg

Title

Administrative Assistant

Phone

(480) 654-1800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Christian Care Manor IV Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1245971944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6945 E MAIN ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852078206",
            "telephone_number": "480-654-1800",
            "fax_number": "480-218-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 S 70TH ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852081007",
            "telephone_number": "480-654-1800",
            "fax_number": "480-218-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN HOUSING-MESA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "KLEVENBERG",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "480-654-1800"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123160",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Care Manor IV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick D. Christensen, D.M.D.
• Tasha Christenson
• Christian Care Management II, Inc.
• Christian Care Mesa, Inc.
• Christian Care Nursing Center, Inc.
• Christian3 Mega Clinic LLC
• Daniel Joseph Christiano Jr., PH.D.
• Doris Ann Christiansen, RN, IBCLC, RLC
• Emma Christiansen
• Marcia W. Christiansen, BS MS

• Assisted Living Facility in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Assisted Living Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.